Raised serum TNF-alpha, blood sugar and uric acid in preeclampsia in third trimester of pregnancy

Abstract

In preeclapsia, insulin resistance occurs but the exact cause is unknown. It is uncertain whether women destined to develop preeclampsia have preexisting insulin resistance or it is acquired with the development of the disease. Fasting blood samples were collected from 10 normal control pregnant women and from 30 cases of preeclampsia in the third trimester of pregnancy to measure circulating level of glucose, uric acid and tumor necrosis factor-alpha (TNF) concentrations. Preeclampsia was diagnosed as per standard guideline adapted from national high blood pressure education program working group. In control group (n=10) mean age was 25±3.71 years, mean sugar level was 86.73±13.06 mg/dl, uric acid level was 3.25±0.59 mg/dl and TNF-alpha level was 9.93±9.56 pg/dl. In preeclapsia group mean age was 25.56±3.96 years, mean sugar level was 93.46±18.6 mg/dl, uric acid was 6.00±1.64 mg/dl and TNF-alpha level was 67.66±61.83 pg/dl. Statistical analysis done using Kruskal Wallis's test showed significantly raised levels of TNF-alpha (p<0.001), uric acid (p<0.001) and blood sugar (p=0.201) in preeclampsia cases. In preeclampsia there was positive significant correlations of raised TNF-alpha with uric acid (p<0.005). Spearman's test for correlation showed positive correlation of TNF-alpha with blood sugar (p<0.043) in cases of preeclampsia. The findings suggest the involvement of cytokines (TNF-alpha) in preeclampsia and may have a role in gestational diabetes mellitus and insulin resistance. In the present study, there was positive association of raised level of TNF-alpha with blood sugar / and uric acid levels.